Originally Posted by Eight

Here are some things that I think might help in the mean time to help with the pain or possibly instead of having more surgery:

1. This is the easiest. Get a 4" cervical collar (order off amazon) and wear it at night. It will help stretch out the scalenes and give you more room in your toracic outlet.
I have used one of these in the past to help with the neck tightness, but have not used it in a couple of years. I will have to see if I can find it and start using it at night.

2. Take some aspercream and rub it on the sides and front of your neck at night. Then place a heating pad for a while under the cervical collar to further stretch/relax the scalenes. Also, hot bath with clove essential oil (antiinflamitory) and epsom salt followed by massaging mustard oil into the neck to relax the scalenes. Stretch your neck several times a day all the way around in a circle.
I used Capzasin-HP prescription strength for years until my body was use to it. I have not tried it for 4-5 years and maybe it will be effective again.

3. See if your doctor will prescribe you a TENS unit for home and also if your insurance will pay for it. I have an EMPI TENS unit. Daily use really helps with the nerve pain. Incidently, my nerve pain is worst in my left arm too. About 20 minutes a day really helps if I am disciplined enough to do this.
I have two of these already from the VA. I use to wear one 6-8 hours a day, but after 2-3 years of this I started having a reaction to the glue in the patches and would itch very bad for 2-3 days afterwards. I have a newer model that had reusable patches that my wife used on her hip, I will see if I can get new patches for it. The current patches are too old and will not stick to my skin.

4. Exercise in a warm water pool - if you live near one, this is a lifesaver for me.
I will have to look for this around me.

5. Muscle Relaxer Medications - I've taken Zanaflex but didn't like it that much. I now take Soma, 350 mg up to 4 times a day. This medicine is great, but doctors don't like to prescribe it because it is addictive and some people abuse it (by abuse I mean they take 8 pills along with a couple hydrocodone, crazy people that want to die) Flexeril is also a good one, but only at night because it makes you really sleepy, also it makes your memory not that great.... Skelaxin is a great one that I take up to a couple of times a day it, it doesn't mess with your brain at all (though I don't recommend taking it with gabapentin because it slurred my speech even though my mind was clear, people thought I was drunk a lot).
I have tried all these medicines except for the Soma. I am currently taking the zanaflex 2mg every 8 hours, I keep trying to take the full pill 4mg but it makes me too sleepy / tired to work. I work in and industrial environment.

6. Nerve Pain Medicaiton - I've never had much luck with these. Gabapentin works the best as far as nerve pain goes, literally it made my nerve pain go away completely, but each time I took it I also gain 60 pounds, so I am not willing to take it. Perhaps you could try Lyria at a higher dose? Also, another option is Keppra - I had some success with this, but I was taking another med that didn't go well with it. I did lose weight on the Keppra though, so that was a plus for me. I see a neurologist for the nerve pain medication and the muscle relaxers.
I took Gabapentin 2700 mg every 8 hours for about a year but stopped taking it after I could not see any reduction in the TOS symptoms while taking it.

7. Botox in the anterior and middle scalene and right pec minor - a non surgical option if you can find someone in your area that does the ultrasound guided botox. I would recommend this before deciding on surgery, because it gives you a good idea of what muscles are actually causing the TOS and what they should be removing during the surgery.
Botox is something I am looking at trying.

Also, I take Tylenol Arthritis 3 x daily along with Tramadol XR 200 mg, it seems to make this medication more effective.


Don't give up, there are many more options out there for you!!! Keep on fighting!!